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Compare/N94 vs R16

N94 vs R16

N94 (Pain and other conditions associated with female genital organs and menstrual cycle) compared with R16 (Hepatomegaly and splenomegaly, not elsewhere classified), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. R16 carries an Excludes2 note covering N94: “symptoms referable to female genital organs (N94.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

N94Pain and other conditions associated with female genital organs and menstrual cycleR16Hepatomegaly and splenomegaly, not elsewhere classified
Billing statusNon-billable header

Report instead: N94.0, N94.10, N94.11, N94.12, N94.19

Non-billable header

Report instead: R16.0, R16.1, R16.2

ClassificationN00-N99 — Diseases of the Genitourinary System (N00-N99)R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
DefinitionPain and other conditions associated with female genital organs and menstrual cycle is a non-billable ICD-10-CM category code (N94).Hepatomegaly and splenomegaly, not elsewhere classified is a non-billable ICD-10-CM category code (R16).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources